〔补胆猛将〕乌梅〔次将〕枣仁
〔泻胆猛将〕桔梗、青皮〔次将〕柴胡、香附、秦艽、川芎
〔凉胆猛将〕龙胆草〔次将〕青蒿、槐实
〔温胆猛将〕肉桂、细辛〔次将〕山茱萸
温胆汤 治胆气虚寒。梦遗精滑等症。
制半夏(一钱五分) 枳实(八分) 陈皮 茯苓(各一钱五分) 人参(一钱) 熟地
炒枣仁(各三钱) 远志(一钱) 五味子(一钱) 甘草(炙五分) 生姜(三片) 枣(一枚)
小柴胡汤 四君子汤 逍遥散(以上三方俱见卷一) 安神定志丸(见心部) 二陈汤(见肝部)
(手阳明属腑)
大肠者。肾阴之窍。传道之官。受事于脾胃。而与肺金相表里。故肺气虚则肠若坠。而气为之
陷。肠液少则肺亦燥而鼻为之干。其呼吸甚密迩也。然肠口上接小肠。下通谷道。为诸脏泄
气之门。启闭一失职。而诸脏困矣。大肠无表症。皆属于里。
大肠虚者。气虚也。脉右尺必沉弱。其症为久痢。为脱肛。
久痢者。气血不足也。归脾汤、十全大补汤、补中益气汤加乌梅均可。脱肛者。气虚下陷也。
补中益气汤加荷叶主之。
大肠实者。胃实移热也。脉右尺必洪实。其症为便闭。为脏毒。为燥渴谵语发狂。为肠痈。
便闭者。实火闭也。小承气汤主之。脏毒者。肠胃不清。下如鱼肠。如豆汁也。芍药甘草汤主之。燥渴
谵语发狂者。燥屎不出也。小承气汤主之。肠痈者。当脐而痛。溺数如淋。千金牡丹皮散主之。
大肠寒者。积冷也。脉右尺必沉迟。其症为久痢。为便血。
久痢者。腹绵绵痛。寒积在肠也。鸦胆子包粉团吞之。便血者。肢冷喜热。寒在肠也。附子理中
汤加归、芍主之。
大肠热者。肺经移热居多。脉右尺必数。其症为便血。为肠风。为脱肛。
便血者。口燥唇焦。热在肠也。芍药甘草汤加黄芩、丹皮、生地。肠风者。脏腑有热。风邪乘之。
故下血而腹不痛。清魂散主之。脱肛者。肠有火则脱出难收。肿而痛也。三黄解毒汤加知母、荷叶主之。
【补胆猛将】乌梅 【次将】枣仁
【泻胆猛将】桔梗、青皮 【次将】柴胡、香附、秦艽、川芎
【凉胆猛将】龙胆草 【次将】青蒿、槐实
【温胆猛将】肉桂、细辛 【次将】山茱萸
温胆汤(Gallbladder-Warming Decoction):治疗胆气虚寒(Gallbladder Qi deficiency and cold),症见梦遗精滑等。
制半夏(Processed Pinellia Rhizome,一钱五分)、枳实(Immature Bitter Orange Fruit,八分)、陈皮(Aged Tangerine Peel)、茯苓(Poria,各一钱五分)、人参(Ginseng Root,一钱)、熟地黄(Prepared Rehmannia Root,炒枣仁 Fried Ziziphus Seed,各三钱)、远志(Polygala Root,一钱)、五味子(Schisandra Fruit,一钱)、甘草(Licorice Root,炙制五分)、生姜(Fresh Ginger Slice,三片)、大枣(Jujube,一枚)。
小柴胡汤(Minor Bupleurum Decoction)、四君子汤(Four Gentlemen Decoction)、逍遥散(Free and Easy Wanderer Powder)(以上三方均见于卷一);安神定志丸(Calming the Spirit and Stabilizing Will Pill)(见心部);二陈汤(Two Aged Ingredients Decoction)(见肝部)。
(手阳明经属于腑)
大肠(Large Intestine)是肾阴(Kidney Yin)的窍道,是传导糟粕的官职,受命于脾胃(Spleen and Stomach),并与肺金(Lung Metal)互为表里。因此,肺气虚则肠道感觉下坠,气机随之陷下;肠液不足则肺部亦干燥,鼻孔因而干涩,呼吸变得非常急促。然而,肠口上接小肠,下通肛门,是各脏腑排泄浊气的门户。一旦启闭功能失职,各脏腑都会陷入困境。大肠没有表证(Exterior syndrome),所有病症都属于里证(Interior syndrome)。
大肠虚者,即气虚(Qi deficiency)。脉象右尺部(Right Cunchi pulse position)必定沉弱(Deep and weak)。症状表现为久痢(Chronic dysentery)、脱肛(Rectal prolapse)。
久痢者,因气血不足(Qi and blood deficiency)。归脾汤(Guipi Decoction)、十全大补汤(Comprehensive Great Tonifying Decoction)、补中益气汤(Buzhong Yiqi Decoction)加乌梅均可使用。脱肛者,因气虚下陷(Qi deficiency with sinking)。以补中益气汤加荷叶为主治方。
大肠实者,由胃实(Stomach excess)移热所致。脉象右尺部必定洪实(Surging and solid)。症状表现为便闭(Constipation)、脏毒(Zangdu/Toxic accumulation in organs)、燥渴谵语发狂(Dry thirst, delirious speech, and madness)、肠痈(Intestinal abscess)。
便闭者,为实火闭塞(Excess fire obstruction)。以小承气汤(Minor Chengqi Decoction)主治。脏毒者,肠胃不清,大便下如鱼肠、豆汁状。以芍药甘草汤(Peony and Licorice Decoction)主治。燥渴、谵语、发狂者,为燥屎不出(Dry stool retention)。以小承气汤主治。肠痈者,脐周疼痛,小便频数似淋证。以千金牡丹皮散(Thousand-Gold Moutan Cortex Powder)主治。
大肠寒者,为积冷(Accumulated cold)。脉象右尺部必定沉迟(Deep and slow)。症状表现为久痢、便血(Hematochezia)。
久痢者,腹部绵绵作痛,因寒积在肠。用鸦胆子包粉团吞服。便血者,四肢冰冷喜暖,因寒在肠。以附子理中汤(Aconite and Poria Decoction)加当归、白芍主治。
大肠热者,多为肺经移热(Heat transferred from Lung meridian)。脉象右尺部必定数(Rapid)。症状表现为便血、肠风(Changfeng/Blood in stool due to wind-heat)、脱肛。
便血者,口燥唇焦,因热在肠。以芍药甘草汤加黄芩、牡丹皮、生地黄主治。肠风者,脏腑有热,风邪乘虚而入,故下血而腹部不痛。以清魂散(Qinghun Powder)主治。脱肛者,肠中有火则脱出难收,肿胀且疼痛。以三黄解毒汤(Three-Yellow Detoxification Decoction)加知母、荷叶主治。
[Generals for Tonifying Gallbladder] Wumei (Mume Fruit) [Lieutenants] Zaoren (Ziziphus Seed)
[Generals for Draining Gallbladder] Jiegeng (Platycodon Root), Qingpi (Citrus Reticulata Pericarpium) [Lieutenants] Chaihu (Bupleuri Radix), Xiangfu (Cyperi Rhizoma), Qinjiao (Gentianae Macrophyllae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma)
[Generals for Cooling Gallbladder] Longdancao (Gentianae Radix et Rhizoma) [Lieutenants] Qinghao (Artemisiae Annuae Herba), Huaishi (Sophorae Fructus)
[Generals for Warming Gallbladder] Rougui (Cinnamomi Cortex), Xixin (Asari Radix et Rhizoma) [Lieutenants] Shanzhuyu (Corni Fructus)
Wendan Tang (Gallbladder-Warming Decoction): Treats Dan Qi Xu Han (Gallbladder Qi deficiency and cold). Symptoms include nocturnal emission and seminal emission.
Zhi Banxia (Processed Pinelliae Rhizoma, 1.5 qian), Zhishi (Immature Aurantii Fructus, 0.8 qian), Chenpi (Citri Reticulatae Pericarpium), Fuling (Poria, each 1.5 qian), Renshen (Panacis Ginseng Radix, 1 qian), Shudi (Prepared Rehmanniae Radix), Chao Zaoren (Fried Ziziphi Spinosae Semen, each 3 qian), Yuanzhi (Polygalae Radix, 1 qian), Wuweizi (Schisandrae Chinensis Fructus, 1 qian), Gancao (Licorice Radix et Rhizoma, honey-fried 0.5 qian), Shengjiang (Fresh Zingiberis Rhizoma, 3 slices), Zao (Jujubae Fructus, 1 piece).
Xiaochaihu Tang (Minor Bupleuri Decoction), Sijunzi Tang (Four Gentlemen Decoction), Xiaoyao San (Free and Easy Wanderer Powder) (The above three formulas are all found in Volume 1); Anshen Dingzhi Wan (Calming the Spirit and Stabilizing Will Pill) (see Heart section); Erchen Tang (Two Aged Ingredients Decoction) (see Liver section).
(The Hand-Yangming Meridian belongs to the Fu Organ)
The Large Intestine is the orifice of Kidney Yin, the official responsible for transmission, receiving instructions from the Spleen and Stomach, and standing in exterior-interior relationship with Lung Metal. Therefore, when Lung Qi is deficient, the intestines feel like they are falling, and Qi sinks. When intestinal fluids are insufficient, the Lungs also become dry, causing nasal dryness and very rapid breathing. However, the upper opening of the intestine connects to the Small Intestine, and the lower opening leads to the anus, serving as the gate for waste gas excretion from all Zang-Fu organs. If the opening and closing functions fail, all organs will be distressed. The Large Intestine has no Exterior Syndrome; all conditions belong to Interior Syndrome.
Deficiency of the Large Intestine refers to Qi Deficiency. The pulse at the Right Cunchi position must be Deep and Weak. Symptoms include chronic dysentery and rectal prolapse.
Chronic dysentery results from Qi and Blood Deficiency. Guipi Tang (Guipi Decoction), Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction), or Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Wumei can be used. Rectal prolapse results from Qi Deficiency with Sinking. Buzhong Yiqi Tang added with He Ye (Lotus Leaf) is the primary treatment.
Excess of the Large Intestine is caused by Heat transferred from Stomach Excess. The pulse at the Right Cunchi position must be Surging and Solid. Symptoms include constipation, Zangdu (toxic accumulation in organs), dry thirst with delirious speech and madness, and intestinal abscess.
Constipation is caused by Excess Fire Obstruction. Xiaochengqi Tang (Minor Chengqi Decoction) is the primary treatment. Zangdu involves unclear stomach and intestines, with stool resembling fish intestines or bean curd dregs. Shaoyao Gancao Tang (Peony and Licorice Decoction) is the primary treatment. Dry thirst, delirious speech, and madness are caused by Dry Stool Retention. Xiaochengqi Tang is the primary treatment. Intestinal abscess presents with pain around the navel and frequent urination resembling strangury. Qianjin Mudanpi San (Thousand-Gold Moutan Cortex Powder) is the primary treatment.
Cold of the Large Intestine is Accumulated Cold. The pulse at the Right Cunchi position must be Deep and Slow. Symptoms include chronic dysentery and hematochezia.
Chronic dysentery involves continuous abdominal pain due to Cold Accumulation in the intestines. Yadanzi (Brucea Fructus) wrapped in powder balls should be swallowed. Hematochezia involves cold limbs and preference for warmth due to Cold in the intestines. Fuzi Lizhong Tang (Aconite and Poria Decoction) added with Danggui (Angelicae Sinensis Radix) and Baishao (Paeoniae Radix Alba) is the primary treatment.
Heat of the Large Intestine is mostly Heat transferred from the Lung Meridian. The pulse at the Right Cunchi position must be Rapid. Symptoms include hematochezia, Changfeng (blood in stool due to wind-heat), and rectal prolapse.
Hematochezia involves dry mouth and scorched lips due to Heat in the intestines. Shaoyao Gancao Tang added with Huangqin (Scutellariae Radix), Mudanpi (Moutan Cortex), and Shengdi Huang (Rehmanniae Radix) is the primary treatment. Changfeng occurs when internal heat allows Wind Pathogens to invade, causing bleeding without abdominal pain. Qinghun San (Clear Soul Powder) is the primary treatment. Rectal prolapse occurs because fire in the intestines makes protrusion difficult to retract, accompanied by swelling and pain. Sanhuang Jiedu Tang (Three-Yellow Detoxification Decoction) added with Zhimu (Anemarrhenae Rhizoma) and He Ye is the primary treatment.